<%-- 
    Document   : register
    Created on : Feb 14, 2012, 9:58:15 AM
    Author     : administrator2
--%>

<%-- Header Area --%>
<%@ include file="/template/header.jsp" %> 
<%-- End of Header Area --%>


<%-- Content Area --%>
<h1>Register</h1>
<form id="register-form" class="register-form" method="POST" action="/register">   
    <table class="register-form-table" cellspacing="0">
        <tr>
            <td valign="top">
                <fieldset>
                    <legend>Login Information</legend>
                    <table>
                        <tr>
                            <th><label for="email">Email</label></th>
                            <td><input id="email" type="text" name="email" value="" validate="form" require="<b>Required Field Missing</b><br/>Please enter your email address." email="<b>Invalid Email Address</b><br/>Email address must be in the form of example@address.com" /></td>
                        </tr>
                        <tr>
                            <th><label for="password">Password</label></th>
                            <td><input id="password" type="password" name="password" value="" validate="form" require="<b>Required Field Missing</b><br/>Please enter your desired password." regular="<b>Invalid Password</b><br/>The password must be 6 characters or longer." validExpress=".{6,}" /></td>
                        </tr>
                        <tr>
                            <th><label for="confirmpass">Confirm Password</label></th>
                            <td><input id="confirmpass" type="password" name="confirmpass" value="" validate="form" require="<b>Required Field Missing</b><br/>Please confirm your password." compare="<b>Password Mismatch</b><br/>The password and confirm password fields must match." compareTo="password" /></td>
                        </tr>
                    </table>
                </fieldset>

            </td>
            <td>
                <fieldset>
                    <legend>Personal Information</legend>
                    <table>
                        <tr>
                            <th><label for="firstname">First Name</label></th>
                            <td><input id="firstname" type="text" name="firstname" validate="form" require="<b>Required Field Missing</b><br/>Please enter your first name." /></td>
                        </tr>
                        <tr>
                            <th><label for="lastname">Last Name</label></th>
                            <td><input id="lastname" type="text" name="lastname" value="" validate="form" require="<b>Required Field Missing</b><br/>Please enter your last name." /></td>
                        </tr>
                        <tr>
                            <th><label for="gender">Gender</label></th>
                            <td>
                                <label><input name="gender" type="radio" checked="checked" value="M" /> Male</label>
                                <label><input name="gender" type="radio" value="F" /> Female</label>
                            </td>
                        </tr>
                        <tr>
                            <th><label for="birthdate">Birth Date</label></th>
                            <td>
                                <input readonly="readonly" id="birthdate" type="text" name="birthdate" class="birthdate"  validate="form" />
                            </td>
                        </tr>

                        <tr>
                            <th><label for="contact">Contact Number</label></th>
                            <td><input id="contact" type="text" name="contact" value="" validate="form" require="<b>Required Field Missing</b><br/>Please enter your contact number." /></td>
                        </tr>
                    </table>
                </fieldset>
                <fieldset>
                    <legend>Address Information</legend>
                    <table>
                        <tr>
                            <th><label for="addTitle">Address Title</label></th>
                            <td>
                                <input type="text" name="addTitle" id="addTitle" placeholder="sample: My home" validate="form" require="<b>Required Field Missing</b><br/>Please enter your preferred address title."/>
                            </td>
                        </tr>
                        <tr>
                            <th><label for="address">Address</label></th>
                            <td>
                                <textarea name="address" id="address" validate="form" require="<b>Required Field Missing</b><br/>Please enter your current address."></textarea>
                            </td>
                        </tr>
                        <tr>
                            <th><label for="landmark">Landmark</label></th>
                            <td>
                                <textarea name="landmark" id="landmark" /></textarea>
                            </td>
                        </tr>
                    </table>
                </fieldset>
            </td>
        </tr>
        <tr>
            <td colspan="2" align="right">
                <input type="submit" value="Submit" name="register" onclick="return validate('form');" />
                <input type="button" value="Reset" onClick="reload()" />
            </td>
        </tr>
    </table>
</form>

<%-- Footer Area --%>
<%@ include file="/template/footer.jsp" %>
<%-- End of Footer Area --%>
